Anedemin is an evident imitation of Anasarcin. It is marketed as tablets, said to contain the isolated active principles of strophanthus, apocynum, squill and sambucus, chemically combined. The quantities are not stated. The therapeutic claims are copied almost literally from the Anasarcin circulars and are equally false. Anedemin, therefore, conflicts with Rules 1, 5, 6 and 7.
It is recommended that this report be published, with comments.
The reports were adopted by the Council and are herewith published.
W. A. Puckner, Secretary.
Anasarcin
This wonderful remedy, Anasarcin, has already been exposed in these columns (The Journal A. M. A., Jan. 27, 1906), but it deserves additional mention, as it teaches several important lessons of general application. It is a typical example of the revival, under a new name and a thin disguise, of an old, time-worn article, squill, presumably because experience has demonstrated its general inferiority to other drugs. Anasarcin further illustrates the dangers involved in the use of semi-secret nostrums. It also shows how a short experience with a widely advertised but little understood drug is apt to lead to conclusions which more extensive experience demonstrates to be entirely fallacious.
The first lesson is, that formulas are not always what they seem. A hasty glance at the formula of Anasarcin tablets, the basis of the Anasarcin dropsy cure, creates the impression that it is a non-secret remedy; for it is said to represent a combination of the active principles of oxydendron, sambucus and scilla. As a matter of fact, it is a secret nostrum of the insidious kind. A formula which omits the quantities of its potent ingredients means very little. Further than this, we do not hesitate to charge that the claimed composition is a deliberate deception. The circulars emphasize the claim that Anasarcin consists of the isolated principles, and not of the crude drugs. Now, the isolated active principles of sambucus and oxydendron are not on the market, for the good and sufficient reason that no active principles have ever been isolated. Are we to believe that the Anasarcin Company has surpassed the accredited chemists and has discovered such principles and is isolating them? We shall have more to say on this subject presently; but any one in the least familiar with the difficulties attending the isolation of organic principles knows such an idea to be preposterous. Indeed, it is absolutely incompatible with the exhibition of ignorance of the elementary facts of pharmaceutical chemistry which is given by these people when they call the active principles of digitalis and squill “alkaloids.”
It is an axiom that the effects of a mixture can only be understood if the action of its components are known. So far as we know, the physiologic effects of oxydendron and sambucus have never been scientifically investigated, for the simple reason that they are too slight and indefinite to promise results. Both are credited with some slight, obscure diuretic action. Oxydendron, the sour wood or sorrel tree, is a small tree of the heath family, the acid leaves of which are said to be chewed by hunters for their pleasant taste and for the relief of thirst. Sambucus is the common elder. It is most unlikely that these two innocuous substances should play any part in the claimed powerful effect of Anasarcin; they are evidently put in the formula, we do not say in the preparation, to obscure the fact that Anasarcin is composed principally of squill. That this is so can be gathered unmistakably from a study of the pharmacologic action of Anasarcin as described by its promoters:
Acting primarily on the heart and arterial systems through the nerve ganglia, a natural physiologic balance is established between the arterial and venous systems, whereby effusions ... are eliminated.... Coincident with this action there is a noteworthy slowing of the pulse.... If the remedy is pushed, can be brought down to 20 or 30 beats per minute.... Its physiological action is to stimulate the cardiac motor-ganglia through the cardiac plexus of the sympathetic system and at the same time exert an inhibitory influence upon the cardiac fibers of the pneumogastric, thereby dilating the arterioles, slowing the heart’s action, and increasing the force of the systole.... The prolonged diastole allows the ventricle time to completely fill, and the more forcible contraction causes the mitral valve to close more thoroughly and at the same time increases pressure in the coronary arteries, serving thereby the double purpose of relieving pulmonary engorgement and increasing heart nutrition.
Anasarcin will nauseate some persons.